Representatives of Britain’s 35 000 GPs have agreed that family doctors must be involved in the establishment of the walk in health centres which the government has agreed should be set up in England.
Last week the prime minister announced that £30m would be made available this year from the capital modernisation fund to fund the first 20 centres. Up to £280m will be available over three years to promote the centres and develop NHS Direct—the nurse led 24 hour telephone helpline (p 1096).
The prime minister said that the centres would “offer people the opportunity to see a doctor or a nurse face to face. They will open from 7 am until 10 pm weekdays and weekends, to provide information and treatment for minor conditions with or without appointments.”
The General Practitioners Committee agreed that with the current shortage of GPs the initiative could help to address the growth in workload and respond to the demand from patients for wider access. But it was worried that by offering non-emergency out of hours care the clinics could generate additional demands.
General practice’s main features must be kept
During the debate GPC members said that it was important that the main features of general practice were not lost—the comprehensive medical record, the link between patients and practices, and the GPs’ gatekeeper role. They called for the pilots to be properly evaluated with the full involvement of local medical committees, primary care groups, and cooperatives.
The GPC’s chairman, Dr John Chisholm, told the committee that the Department of Health had assured him that the centres were not a threat to list based general practice, that nurses would not replace doctors, and that they could be based in existing practices or cooperatives. He believed that the department was alarmed at the development of commercial medicentres.
“We need confirmation about prescribing and referrals in the centres,” Dr Fay Wilson, who practises in Birmingham, said, but she believed that GPs should be involved.
Other members were more cautious. Dr Jonathan Reggler from Buckinghamshire, said that the centres could increase workload if GPs were obliged to see patients referred from them. He suggested that a working party should be set up to look at the implications. And Dr Brian Keighley from Balfron, West Stirlingshire, said that if there was extra money for general practice it should go to GPs. “It might be a good idea in the future, but not now,” according to Dr Peter Fellowes (Lydney, Gloucestershire). He thought that at a time of cuts in primary and secondary care the concept would undermine all manpower arrangements. 